EVOLVE ELSEVIER HESI MEDICAL-SURGICAL (MED SURG) EXAM
2026 COMPLETE TESTBANK | 500+ ACTUAL EXAM
QUESTIONS CORRECT ANSWERS WITH DETAILED
RATIONALES UPDATED FOR 2026/2027 | GUARANTEED PASS |
GRADED A+
DOMAIN 1: CARDIOVASCULAR SYSTEM
Question 1
A client with heart failure is prescribed digoxin. Which assessment finding
indicates
digoxin toxicity?
A) Heart rate of 58 beats per minute
B) Serum potassium level of 3.2 mEq/L
C) Serum digoxin level of 0.8 ng/mL
D) Blood pressure of 138/88 mmHg
Correct Answer: B
Rationale: Hypokalemia (potassium level below 3.5 mEq/L) increases the risk of
digoxin toxicity. The nurse should monitor potassium levels closely. A heart rate
of 58 bpm is within normal limits for a client on digoxin. A digoxin level of
0.8 ng/mL is within therapeutic range (0.8-2.0 ng/mL). The blood pressure is
slightly elevated but not indicative of digoxin toxicity.
Question 2
A client is admitted with acute myocardial infarction. Which laboratory value is
most specific for diagnosing this condition?
A) Creatine Kinase-MB (CK-MB)
B) Troponin I
C) Myoglobin
D) C-reactive protein
Correct Answer: B
1
,Rationale: Troponin I and Troponin T are the most specific and sensitive cardiac
markers for myocardial injury. Troponin levels remain elevated for up to 10-14
days
after an MI. CK-MB rises and falls more quickly, making it less specific. Myoglobin
is not specific to cardiac tissue. C-reactive protein indicates inflammation but is
not specific to MI.
Question 3
A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in the teaching?
A) "Take one tablet every 15 minutes for up to 3 doses"
B) "Place the tablet under your tongue and let it dissolve"
C) "Chew the tablet for faster absorption"
D) "Take the tablet with a full glass of water"
Correct Answer: B
Rationale: Nitroglycerin should be placed under the tongue (sublingual) and
allowed
to dissolve completely for rapid absorption through the oral mucosa. The client
should take one tablet, wait 5 minutes, and if pain persists, take a second tablet,
wait another 5 minutes, and take a third tablet. If pain persists after 15 minutes
and 3 tablets, they should seek emergency care. Chewing or swallowing the tablet
reduces effectiveness, and water is not needed.
Question 4
Which electrocardiogram (ECG) change is most characteristic of myocardial
ischemia?
A) ST-segment elevation
B) ST-segment depression
C) Q waves
D) Prolonged PR interval
Correct Answer: B
2
,Rationale: ST-segment depression is characteristic of myocardial ischemia,
indicating
inadequate oxygen supply to the myocardium. ST-segment elevation indicates
acute
injury or infarction. Q waves indicate a prior MI (necrosis). A prolonged PR
interval
indicates a first-degree heart block, not ischemia.
Question 5
A client with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor for?
A) Hyperkalemia
B) Hyponatremia
C) Hypokalemia
D) Hypercalcemia
Correct Answer: C
Rationale: Furosemide is a loop diuretic that inhibits sodium and water
reabsorption
in the loop of Henle, leading to increased excretion of potassium. Hypokalemia is
a
common adverse effect. Hyperkalemia is associated with potassium-sparing
diuretics.
Hyponatremia can occur but is less common with loop diuretics. Hypercalcemia is
not
associated with furosemide.
Question 6
A client is being discharged after a myocardial infarction. Which statement
indicates
the client understands the discharge teaching?
A) "I can resume all my normal activities immediately"
B) "I will take my nitroglycerin only when I have chest pain"
3
, C) "I should take my aspirin every day as prescribed"
D) "I don't need to change my diet since I had a heart attack"
Correct Answer: C
Rationale: Daily aspirin therapy is a standard part of secondary prevention after
an
MI to reduce the risk of thrombotic events. Activities should be gradually
increased
with medical guidance. Nitroglycerin should be taken at the first sign of chest
pain.
Dietary changes, including a heart-healthy diet, are essential for secondary
prevention.
Question 7
What is the priority nursing intervention for a client experiencing ventricular
fibrillation?
A) Administer amiodarone IV
B) Prepare for immediate defibrillation
C) Begin chest compressions
D) Insert an advanced airway
Correct Answer: B
Rationale: Ventricular fibrillation is a pulseless, life-threatening arrhythmia.
Immediate defibrillation is the priority treatment to terminate the arrhythmia and
restore a perfusing rhythm. Chest compressions are initiated while preparing the
defibrillator. Amiodarone is administered after defibrillation if the rhythm
persists.
Airway management is important but comes after defibrillation.
Question 8
Which assessment finding is most concerning in a client with peripheral arterial
disease?
A) Cool, pale extremities
4
2026 COMPLETE TESTBANK | 500+ ACTUAL EXAM
QUESTIONS CORRECT ANSWERS WITH DETAILED
RATIONALES UPDATED FOR 2026/2027 | GUARANTEED PASS |
GRADED A+
DOMAIN 1: CARDIOVASCULAR SYSTEM
Question 1
A client with heart failure is prescribed digoxin. Which assessment finding
indicates
digoxin toxicity?
A) Heart rate of 58 beats per minute
B) Serum potassium level of 3.2 mEq/L
C) Serum digoxin level of 0.8 ng/mL
D) Blood pressure of 138/88 mmHg
Correct Answer: B
Rationale: Hypokalemia (potassium level below 3.5 mEq/L) increases the risk of
digoxin toxicity. The nurse should monitor potassium levels closely. A heart rate
of 58 bpm is within normal limits for a client on digoxin. A digoxin level of
0.8 ng/mL is within therapeutic range (0.8-2.0 ng/mL). The blood pressure is
slightly elevated but not indicative of digoxin toxicity.
Question 2
A client is admitted with acute myocardial infarction. Which laboratory value is
most specific for diagnosing this condition?
A) Creatine Kinase-MB (CK-MB)
B) Troponin I
C) Myoglobin
D) C-reactive protein
Correct Answer: B
1
,Rationale: Troponin I and Troponin T are the most specific and sensitive cardiac
markers for myocardial injury. Troponin levels remain elevated for up to 10-14
days
after an MI. CK-MB rises and falls more quickly, making it less specific. Myoglobin
is not specific to cardiac tissue. C-reactive protein indicates inflammation but is
not specific to MI.
Question 3
A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in the teaching?
A) "Take one tablet every 15 minutes for up to 3 doses"
B) "Place the tablet under your tongue and let it dissolve"
C) "Chew the tablet for faster absorption"
D) "Take the tablet with a full glass of water"
Correct Answer: B
Rationale: Nitroglycerin should be placed under the tongue (sublingual) and
allowed
to dissolve completely for rapid absorption through the oral mucosa. The client
should take one tablet, wait 5 minutes, and if pain persists, take a second tablet,
wait another 5 minutes, and take a third tablet. If pain persists after 15 minutes
and 3 tablets, they should seek emergency care. Chewing or swallowing the tablet
reduces effectiveness, and water is not needed.
Question 4
Which electrocardiogram (ECG) change is most characteristic of myocardial
ischemia?
A) ST-segment elevation
B) ST-segment depression
C) Q waves
D) Prolonged PR interval
Correct Answer: B
2
,Rationale: ST-segment depression is characteristic of myocardial ischemia,
indicating
inadequate oxygen supply to the myocardium. ST-segment elevation indicates
acute
injury or infarction. Q waves indicate a prior MI (necrosis). A prolonged PR
interval
indicates a first-degree heart block, not ischemia.
Question 5
A client with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor for?
A) Hyperkalemia
B) Hyponatremia
C) Hypokalemia
D) Hypercalcemia
Correct Answer: C
Rationale: Furosemide is a loop diuretic that inhibits sodium and water
reabsorption
in the loop of Henle, leading to increased excretion of potassium. Hypokalemia is
a
common adverse effect. Hyperkalemia is associated with potassium-sparing
diuretics.
Hyponatremia can occur but is less common with loop diuretics. Hypercalcemia is
not
associated with furosemide.
Question 6
A client is being discharged after a myocardial infarction. Which statement
indicates
the client understands the discharge teaching?
A) "I can resume all my normal activities immediately"
B) "I will take my nitroglycerin only when I have chest pain"
3
, C) "I should take my aspirin every day as prescribed"
D) "I don't need to change my diet since I had a heart attack"
Correct Answer: C
Rationale: Daily aspirin therapy is a standard part of secondary prevention after
an
MI to reduce the risk of thrombotic events. Activities should be gradually
increased
with medical guidance. Nitroglycerin should be taken at the first sign of chest
pain.
Dietary changes, including a heart-healthy diet, are essential for secondary
prevention.
Question 7
What is the priority nursing intervention for a client experiencing ventricular
fibrillation?
A) Administer amiodarone IV
B) Prepare for immediate defibrillation
C) Begin chest compressions
D) Insert an advanced airway
Correct Answer: B
Rationale: Ventricular fibrillation is a pulseless, life-threatening arrhythmia.
Immediate defibrillation is the priority treatment to terminate the arrhythmia and
restore a perfusing rhythm. Chest compressions are initiated while preparing the
defibrillator. Amiodarone is administered after defibrillation if the rhythm
persists.
Airway management is important but comes after defibrillation.
Question 8
Which assessment finding is most concerning in a client with peripheral arterial
disease?
A) Cool, pale extremities
4
